The importance of the individual in PrEP uptake: Multilevel correlates of PrEP uptake among adolescent girls and young women in Tshwane, South Africa

Wendee M. Wechsberg; Felicia Amira Browne; Alexandra Marena Minnis; Laura Nyblade; Jacqueline Wanjiku Ndirangu; Courtney Peasant Bonner; Courtney Peasant Bonner; Alexandra Marena Minnis; Jacqueline Wanjiku Ndirangu; Felicia Amira Browne; Ilene Speizer; Laura Nyblade; Khatija Ahmed; Wendee M. Wechsberg

The importance of the individual in PrEP uptake

Multilevel correlates of PrEP uptake among adolescent girls and young women in Tshwane, South Africa

Bonner, C. P., Minnis, A. M., Ndirangu, J. W., Browne, F. A., Speizer, I., Nyblade, L., Ahmed, K., & Wechsberg, W. M. (2023). The importance of the individual in PrEP uptake: Multilevel correlates of PrEP uptake among adolescent girls and young women in Tshwane, South Africa. AIDS and Behavior, 27(12), 4124-4130. https://doi.org/10.1007/s10461-023-04126-9

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Abstract

Adolescent girls and young women (AGYW) account for 25% of new HIV infections in South Africa. Pre-exposure prophylaxis (PrEP) is approved by the South African Government, but the factors that promote PrEP uptake among AGYW are not well understood. This study examines multilevel factors associated with PrEP uptake among AGYW in six clinic catchment areas in Tshwane (Pretoria), South Africa. After consent/assent, PrEP-eligible AGYW (n = 448) completed a questionnaire assessing factors at the individual, network/interpersonal, and community levels and were prescribed PrEP in study clinics, if interested. A multivariable model, adjusting for clustering, assessed factors associated with PrEP uptake over a 9-month period. At the individual level, multiple partners in the past 3 months (OR = 0.47), perceived risk of HIV (OR = 0.71), and PrEP-related shame (OR = 0.63) were correlated with lower odds of PrEP uptake (ps ≤ 0.05). The findings highlight modifiable factors that should be addressed to support PrEP uptake efforts.